Masui. The Japanese journal of anesthesiology
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Airway scope (AWS) is a rigid indirect laryngoscope with integrated tube guidance and can improve laryngeal exposure compared to the conventional direct laryngoscope. It is expected that the clear and improved laryngeal view obtained with AWS can eliminate the risk of esophageal intubation. We, however, experienced 3 cases of esophageal intubation out of 600 clinical cases with AWS in 15 month after its market release. ⋯ The third case was performed by an experienced laryngoscopist but it was difficult to identify the glottic opening because patient had distracted airway anatomy due to laryngeal tumor. In all cases esophageal intubation was immediately noticed and airway was secured uneventfully. We conclude that intubation under vision with improved laryngeal view is still not sufficient to prevent esophageal intubation.
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Variant conformity blood is often used in transfusion at massive unpredictable hemorrhage under an operation or at hemorrhagic shock in a lifesaving emergency arena. This is because of difficulty in performing blood grouping, because of difficulty in deciding blood types in the laboratory, or because of lack in store of the same blood type transfusion as a pharmaceutical preparation needed for the patients. In performing variant conformity transfusion in the hospital, it is vitally important that in-house system be well-organized and staff be thoroughly informed about variant conformity transfusion. This chapter explains system arrangements of organization for variant conformity transfusion in hospital settings based on our experience in the urgent use of O type RCC-LR (Red Cells Concentrates-Leukocytes Reduce, "Nisseki") pharmaceutical preparation.
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The latest revision of Japanese practical guidelines for the blood component therapy, edited by the Ministry of Health, Labour and Welfare of Japan in 2005, consisted of several crucial points including: emergency red cell transfusion for critically ill patients; the computer crossmatch; and non-erythrocyte blood component therapy based on diagnosis for coagulopathy. The guidelines issued by the Japanese Society of Anesthesiologists as well as the Japan Society of Transfusion Medicine and Cell Therapy (2008) further focused on the strategy for perioperative massive blood loss. Seven feature articles following this opening article summarizes the topics for the new frontier in perioperative blood component therapy in Japan.
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Randomized Controlled Trial Comparative Study
[Use of gum elastic bougie for tracheal intubation: comparison of different tracheal tubes].
Gum elastic bougie (GEB) is one of the most useful devices for patients whose tracheas are difficult to intubate during anesthetic induction. But no previous study has evaluated the effects of the types of the tracheal tube. We hypothesized that wire-reinforced tracheal tubes were superior to standard tracheal tubes in the success rate of tracheal intubation when using GEB. We compared these two different types of tracheal tubes in using GEB. ⋯ The type of tracheal tube would not affect the success rate and time of intubation when using gum elastic bougie.
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Comparative Study
[Prevention of postoperative nausea and vomiting by metoclopramide combined with dexamethasone in gynecological surgery].
The authors evaluated the efficacy of a combination of dexamethasone and metoclopramide for the prophylaxis of postoperative nausea and vomiting (PONV) after gynecological abdominal surgery. ⋯ A combination of metoclopramide and dexamethasone was more effective in preventing PONV compared with metoclopramide alone.